Infection Control and Hospital Epidemiology
Volume 37, Issue 11, 2016, Pages 1310-1314

Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children's Hospital in Germany 2015-2016 (Article) (Open Access)

Tenenbaum T.* , Becker K.-P. , Lange B. , Martin A. , Schäfer P. , Weichert S. , Schroten H.
  • a Pediatric Infectious Diseases, University Children's Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany
  • b Administrative Department of Hygiene, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • c Administrative Department of Hygiene, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, Department of Pediatric Surgery, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany
  • d Institute for Medical Microbiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • e Public Health Department Mannheim, Mannheim, Germany
  • f Pediatric Infectious Diseases, University Children's Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany
  • g Pediatric Infectious Diseases, University Children's Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany

Abstract

OBJECTIVE To determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany. DESIGN Retrospective observational study. SETTING General pediatric and pediatric surgery units. PATIENTS In Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016. METHODS Using electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees. RESULTS Among 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycin-resistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate. CONCLUSION Implementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted. Infect Control Hosp Epidemiol 2016;1-5. © 2016 by The Society for Healthcare Epidemiology of America. All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Germany refugee drug effects Escherichia coli gastroenteritis university hospital human Communicable Diseases Refugees Drug Resistance, Multiple, Bacterial Humans Hospitals, University Adolescent male preschool child Staphylococcus aureus Infant Enterococcus faecium Child, Preschool female observational study refugee camp Klebsiella pneumoniae prevalence isolation and purification Gram negative bacterium Article Retrospective Studies communicable disease multidrug resistance Gram negative infection Feces major clinical study Gram-Negative Bacteria vancomycin resistant Enterococcus microbiology bacterium isolate antiinfective agent retrospective study Anti-Bacterial Agents Gram-Negative Bacterial Infections pediatric ward methicillin resistant Staphylococcus aureus Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992365173&doi=10.1017%2fice.2016.179&partnerID=40&md5=a03324b90039b243e91a5fe83703522c
DOI: 10.1017/ice.2016.179
ISSN: 0899823X
Cited by: 16
Original Language: English